Do You Have Heel Pain?

Plantar fasciitis is a condition that is common amongst middle aged people and runners. The most common complaints of a person with plantar fasciitis is that they have pain in the bottom of their heel that is killing them at the first step out of bed in the morning. The pain will get worse if they have been sitting down and resting and then stand back up. There are few things that relieve the pain, but pain killers and icing your heel will help.

So, what exactly is this condition? It is called plantar fasciitis and results when a band on the bottom of your foot is overstretched and becomes irritated. The constant stretching of the band makes it very sore, and can actually cause microtears in the fascia. Once this happens, you will have pain after you have been resting because your fascia had a chance to return to its regular size.

So, what can you do for this condition? Well, the icing will certainly help. But, it is really important to help your fascia heel. This can be done by giving you a steroid shot in your heel. This injection will help to relieve the inflammation surrounding your fascia. This will also help to reduce the pain so that you can do the physical therapy of your plantar fascia. You can do this by freezing a water bottle and rolling it under your heel. This will help to numb the area and take away more of your inflammation.

You can then use orthotic inserts to let your foot sit in a position to take the pressure off of the band. This will allow the plantar fascia to heal and provide you relief. You can also use a night brace while sleeping to hold your foot in a favorable position. If the plantar fasciitis is not treated and continues to get worse, it can actually cause the plantar fascia to rupture.

If you are having pain in your heel, you should go and visit your local podiatrist so that they can determine what is causing your pain. If you live in the Boston or Dracut, Massachusetts area, Dr. Wachtel would be more than happy to see you and help determine the best treatment for your condition. We are also happy to announce our Methuen and North Andover offices located at 451 Andover St. Suite 300, North Andover MA 01845 and 87 Jackson St, Methuen, MA 01835.

Olympic Hopeful's Achille's Heel

Achilles injuries are typically touted as being due to obesity and a sedentary lifestyle. Gradually overtime the tendon becomes weakened which leaves it more prone to injury, especially with a bad step or a new workout plan. Achilles injuries can also be due to being worked hard, such as in a runner. A recent example in the news of this incidence is Olympic hopeful Jenny Meadows from London. She is set to compete in the trials for qualifications, but her recent reinjury to her Achilles tendon may make it better for her this year.

There are many different levels of injury to the Achilles tendon dependent upon how severe the actual injury is. Two imaging modalities that are great for visualizing the tendon are Ultrasound and MRI. On an MRI, you are able to determine if the injury is taking up part of the tendon or the entire thing. Injuries are classified as being minor or major partial tears or a complete rupture. The level of your injury will determine the course of action that is best for your treatment.

For smaller injuries, a great modality is laser treatment of the injured area. Laser treatment consists of treating the area with a specific wavelength of energy that will stimulate the area to become an acute injury again allowing all of the cells necessary for proper healing to migrate to the area once again. By giving your body the chance to heal this area as an acute injury, it means that you are much more likely to see the strength and quality of your once injured tissue return to that of its pre-injury quality.

If the injury is more severe, immobilization to provide the injury with time to heal followed by physical therapy to regain strength may be the best option. Finally, if the tendon has actually ruptured then surgical treatment is the recommended course to reattach the tendon to its proper location.

An Achilles injury can range from a pain level of barely any clear up to excruciating pain at your heel. This is why if you notice any swelling in the area or bruising, it is very important to seek consult from your podiatrist. If you or someone you know has suffered from any level of Achilles injury, our office staff would be more than happy to schedule an appointment for you. Our offices serve the Methuen, Lowell, Burlington and Stoneham, Massachusetts.

Shoes, Shoes, Shoes!

Many people have a tendency to forget about their feet and just how important they are. They are often viewed as a luxury, because you just get up each morning and walk around forgetting that every step you are doing and every action that you are taking is directly affected by your feet. On the same level, every motion that you are taking affects your feet. For these reasons, your shoe wear is extremely important because it provides your feet the support that they need.

There is a common misunderstanding throughout the population that a pair of shoes requires a good breaking in before your feet will be comfortable. Unfortunately, this is just not true. For instance, high heel shoes should not be rubbing blisters on your heels every time that you buy a new pair. The reality is though, most women purchasing high heels have to buy a size that is too small for them in order for their feet to not slip out of them. As a result, after a long night out on the town, many women will go home to nurture those blisters that have popped up at each of the pressure points of their shoes. Just as easily though, you can apply this to running shoes that are too tight and rub up against your pressure points causing just as many blisters. The only reason that you don’t get blisters after a while is partially because the shoe may stretch out a bit to better fit your foot, but it’s mainly because your skin will get harder in that area preventing these blisters from forming. But, boy is that a painful price to pay for a pair of shoes.

With as many people as are running and exercising these days and the improvements in technology, there is a shoe type for every foot type. The most important thing you can do for your feet is come in for a consult, where your foot type will be determined and suggestions can be made for the particular brands that carry a shoe that fits your foot type. As far as dress shoes, everyone has had at least one experience with uncomfortable dress shoes, if not many more. This problem can be remedied by examining your foot type as well. For instance, if you have a wide foot then you will need a wider area for your toes to fit so that you aren’t rubbing blisters on the inside of your big toe or outside of your little toe.

If you or someone you know struggles with finding shoes that fit your foot, then a consult with Dr. Wachtel to look at your foot type could be very helpful. If you live in the Methuen, North Andover, North Billerica or Burlington, Massachusetts area, our office staff would be more than happy to schedule an appointment for you. There is no reason that your shoes should be causing you pain every day, so before you go barefoot through the office, give us a call so that we can find the best shoe for you.

Clayton Keyshaw's Plantar Fasciitis

LA Dodgers pitcher Clayton Keyshaw has been reported to suffer from plantar fasciitis. He claims that although his foot is in a good deal of pain, it does not inhibit him from pitching, only running. As a result, fans and the coaching staff have expressed concern for  his injury, but he is pushing through and seeking the necessary treatment to continue to pursue his love for baseball.

Plantar fasciitis is an injury that occurs when the connective tissue sheath on the bottom of your foot is overstretched repeatedly, causing micro tears within the fascia. The plantar fascia connects the heel bone to the area of your foot that is right before your toes. As you walk, run, jump, or do any motion that involves flexing and relaxing your foot, you are putting a stretching motion on this tissue. For people that do a lot of running, standing on uneven surfaces (like a roof) or are just starting to age, the plantar fascia is an area of concern for injury.

Plantar fasciitis is a condition that has very specific symptoms in the average presentation. You will have a great deal of pain on the inside portion of your heel when you first wake up in the morning and take your first steps or after you have been sitting down and resting throughout the day. This pain signifies that these micro tears are in the very beginning stages of healing, but then you stand up and start to move, irritating and stretching the area, and this will result in putting a strain on those inflamed areas.

So, treatment for plantar fasciitis is very dependent upon the individual case. These micro tears, if untreated for a long time, can lead to rupture of your plantar fascia. When this occurs, surgery will need to be done. But for most of us, we will not advance to that level of injury and so for many cases, there are several other options. One of these is giving a corticosteroid shot to block the inflammation to the area and reduce the pain and then immobilizing your foot so that it can heal by not having stress on the injured areas.

Another option for plantar fasciitis is a non-invasive low energy laser that will stimulate the tissue to move from a chronic injury setting to acute. What this does is it brings in all of the cells that are useful for healing the tissue and returning it to its original state.

If you or anyone you know has been suffering from heel pain in the Methuen, Tewksbury, Bradford, Westford or North Billerica, Massachusetts our office staff would be more than happy to help you schedule an appointment. Dr. Wachtel will be able to help  you determine what your underlying cause is and get you back up on your feet again.

Skechers Shape-ups Settlement

Sketchers has recently agreed to pay a 40 million settlement to refund people for their purchase of Shape Ups. Claims have been made that the company mislead consumers with false information claiming that these shoes would make you fit by just walking around. People have been outraged at the amount that they paid for no results. Skechers does claim however, that they were targeting young women that were already in shape and it was just supposed to be extra boost.

The truth about the shape up shoes is two-fold. First, wearing a particular kind of shoes is not going to make you look like Tyra Banks or any other toned individual. The reality is that kind of fitness takes hours in the gym paired with good nutrition and self-discipline. As nice as it would be to find the miracle cure, unfortunately you just have to get out there and work-out. The second thing that is important to know about these shoes is that they are used in podiatric medicine. However, they are not used for people who want to tone their legs, but instead they are used for people who do not have enough range of motion in their joints to meet the requirements for walking. This shoe is referred to as a “double rocker” and it allows your foot to roll through the gate cycle and push off the ground. They are a very unstable shoe though and so they are only prescribed for one foot due to their inherent instability.

Podiatrists have a vast array of shoe modifications in their tool bag for treatment. These include different types of shoes, padding to off-load a painful joint or bump and orthoses to hold your foot in a position favorable to your everyday activities. Unfortunately, none of them are marketed as being a weight loss miracle. However, for the people who have painful bunions, limited range of motion, high arches, heel pain, plantar fasciitis, and a whole slew of other conditions these modifications can give them unbelievable relief.

If you or someone you know in the Methuen, Lowell, North Andover, Tewksbury or Boston Massachusetts area are suffering from a painful foot, our office staff would be more than happy to help you schedule an appointment. Dr. Wachtel will be able to help you figure out the best treatment plan and get you back up and on the go.

Laser Treatment for Heel Pain

Plantar Fasciitis is a condition characterized by a sharp pain in your heel when you wake up in the morning or after you stand up after a long time of sitting. Plantar Fasciitis can result from having certain foot types including being flat footed, from being obese, from being active with running or things such as standing for a long time with shoes that don’t have good support. The plantar fascia is a stretch of tissue that goes from your heel to the base of your toes. When it is constantly stretched over and over again it can for microtears in the fascia causing inflammation. This is the basis behind plantar fasciitis.

Plantar fasciitis can be a debilitating condition due to the amount of pain that it causes. This can make it very difficult to be able to get up out of bed in the morning or standing up again. There are several different treatment plans for this condition, including steroid shots, stretching exercises and orthoses. Another option though is laser treatment. This treatment works by aiming a light beam towards the injured area that stimulates the healing nature of cells. This takes your injury from a chronic state that does not have the necessary healing properties and take it back to an acute healing state.

Laser treatment requires several treatments to fully restore the tissue. This therapy has seen remarkable results and has shown significant improvements in the majority of individuals. There are very few contraindications to this treatment and those include people who are pregnant or those with tumors in the area.

Laser therapy is just one form of treatment for people who are suffering from plantar fasciitis. Dependent upon your particular foot type and condition, the best treatment plan for you can be determined. If you or someone that you know in the North Andover, Methuen, Tewksbury and Boston, Massachusetts has been experiencing heel pain, our office would be more than happy to help you make an appointment.

Heel Spurs: Not Just for Horses

Have you ever felt pain on the bottom of your heel? This pain could be as a result of a bone spur which is caused by extra bone growth. This extra bone can end up tearing or rubbing against soft tissue at your heel resulting in irritation that causes inflammation and swelling.

Extra bone is not something that forms in your body simply because it wants to. It is the result of some amount of injury, extra pressure, stress or rubbing that causes the extra bone to form as a way of “protecting” your body. Extra bone can also form as a result of tight ligaments. This can occur due to running, poorly fitting shoes or even being overweight. When the ligament is tight and pulls on the area, the area becomes inflamed and it causes the extra bone to form. These bone spurs can often exist without causing you any pain or discomfort. But in some instances, it can become pronounced enough that it causes discomfort. In order to confirm that a bone spur is the cause, x-ray imaging is necessary to visualize the area.  

There is a wide variety of treatment that can be used for heel spurs. Starting with the basics of resting your foot, ice and anti-inflammatory treatment we can gauge whether your bone spur needs more treatment or not. If this does not work, then there are other treatments that can be considered. Another option is padding in the heel part of your shoe. If this works, orthoses can be designed that include the padding built into your orthoses. This serves as a more permanent way to treat your condition while still using the padding. Dependent upon your foot type, there are both custom and general orthoses. By talking to your podiatrist, they can determine which type of treatment is best for you.

If you or someone you know has heel pain and you live in the Methuen, North Andover, Boston, Lowell or Bradford area our office staff would be more than happy to help you set up an appointment and get you back up on your feet as soon as possible.

Does Dwyane Wade have Plantar Fasciitis?

The Miami Heat’s point guard Dwyane Wade has sat out the past couple of games due to a foot injury that neither he nor the trainers are quite sure what it is from. In a recent press interview one of the reporters throughout the term plantar fasciitis and the Heat coaches and Dwyane Wade were not able to definitely say whether or not this is the cause. He is currently working with physicians to figure out what exactly is going on but is hoping to get back to the game quickly.

Plantar Fasciitis is a condition that results from inflammation and injury to a sheet of tissue that lies across the bottom of your foot. It extends from your heel and connects to the base of your toes. Typically an injury to this fascia results from micro-tears occurring over a long period of time due to your foot type. You will feel the pain on the bottom of  your heel and it will sometimes extend up your leg. If you have a tendency for your foot to flatten out when you are walking or you sleep on your stomach with your feet flattened out, it can cause a constant stretching and strain on this tissue. Over time, the stretching will cause these tears and result in inflammation causing a great deal of pain. Typically, it is at its worst in the morning when you wake up or after you have been resting throughout the day and then start to move around again.

There are different types of treatment for plantar fasciitis. One of them is laser treatment that can be done by your podiatrist. This is a non-invasive and non-painful treatment. It works by causing your injury to move from a chronic injury back to an acute one. The main point of this is to force your body’s cells that function in healing to start working again. They will be stimulated to move back into the affected area and begin the healing process to fix your injury. It will take some time for you to notice the effects because your body has to recover from injuries that occurred over a long period of time. In the meantime, you may be a candidate for a cortisone shot that will give you quick relief while your body is in the healing process.

So, in summary, if Dwyane Wade does indeed have Plantar Fasciitis, it may take him awhile to recover from his injury. Luckily for him, he is in great shape and his immune system should be working its hardest to get him back out on the court.

How to Strengthen Your Achille's Heel

Achille’s tendonitis causes pain on the back of your heel. It is often exacerbated by long runs, new exercises and aging. It starts as a bit of a throbbing at your heel and progresses to a sharp stabbing pain that can be debilitating. This pain is a result of minor repetitive trauma that causes small tears in the tendon. As the tendon is used again and again you can cause the tears to become inflamed and undergo acute inflammation. However, the injury can be fixed before the tendon progresses to a full rupture. One way to do this is through exercises to strengthen your Achilles tendon.  The following exercises can help you to do this, but as with other exercising, it is all about consistency.

1.       Calf Raise: Stand on the edge of a stair and raise your foot to where you are standing on your toes. Lower yourself slowly until you feel the muscle stretching. This is your gastrocnemius and your soleus that attach to the Achilles tendon. It is important to do one foot at a time to maintain stability. Make sure that you do both feet so that you are strengthening both tendons.

2.       Resistance Band: While sitting, loop a resistance band around your foot and point your toes. Then pull the resistance band towards you while keeping your toes pointed. This will also increase your strength.

These two exercises will quickly strengthen the muscles in your calf and will therefore increase the strength of your Achilles as well. You should notice changes relatively quickly, but it is important to halt your exercise routine while you are strengthening the tendon. After you have been cleared by your podiatrist to start training again, it is safe to return. However, should you feel pain again; you should seek medical attention for further treatment.

Posterior Tibial Tendon Rupture

Your posterior tibial tendon runs along the inside of the back of your heel and down onto the bottom of your foot. Many times, this tendon will be injured as a result of someone being overly aggressive with a new workout plan. The tendon will become irritated and inflamed and if the person does not heed their body’s warnings, then the tendon can actually split in half. The tendon can also rupture due to people who have flat feet or are obese. In both of these cases excessive pressure is being placed on the tendon and it eventually is compromised due to the stress of the pressure. If you do not notice a sharp pain, because not all people will, you may notice that your foot is more flat or that your foot rolls inward where it did not in the past.

Treatment for this condition ranges from bracing to surgery. The steps that are taken are all dependent on how far the injury has progressed. In individuals who did not notice the pain initially, their ligaments can stretch causing the foot to flatten out even more. The bones will eventually shift and the entire foot may change shape from its original form. In all patients, x-rays and ultrasound can be performed to help decide what treatment needs to be done.

For the early stages, a brace can be used to hold the tendon stationary. This will allow the tendon to reconnect and prevent further inflammation from occurring. Orthoses can be used to correct the flatfoot and hold the foot in a more stable position. For people who have progressed to a more severe flatfoot, casting may be able to be used, but for some people, the foot will not be able to reach the more stable position because the ligaments have gotten tighter. This tightness prevents flexibility and the foot is not able to be moved out of the flat position. For these people surgery can be used to reattach the ligament and realign the bones that are causing the flat foot and the pain associated.

The key to any injury is a fast reaction time. It is important that as soon as you notice a change in your foot from the way that it has always been that you seek medical consult from your podiatrist. The quicker that you come in for a consult, the faster we can nip the problem in the bud and get you back on your feet.

Sever's Disease

Is your child suffering from heel pain? Well, it is possible that they may be suffering from a condition termed Sever’s Disease. This condition normally starts around age 10 to 16, but may occur earlier or later depending on your child’s growth. When your child is born, the majority of their bones are actually made of cartilage. As your child develops, this cartilage will be replaced with bone to give them the skeleton that we are all used to seeing. This process takes many years though and some of their bones will not be finished until they are around 20 years old. In the heel bone, there are two different areas that the bone originates from, in the middle and where your Achilles tendon attaches. When these two areas meet up, they may start to rub against one another causing irritation in your child’s heel. This is often exacerbated in very active kids because they are moving around much more which causes a greater amount of rubbing to occur.

Some of the things that you can do include limiting your child’s activity and making sure they get plenty of rest. But, let’s be honest, most kids can’t sit still for even five minutes. So, in order to help their active lifestyle your podiatrist has several options that may benefit your child. The first thing that will be done is evaluate them to make sure that there are no other underlying causes of your child’s pain. If it is in fact determined to be Sever’s disease, then we can look into foot orthoses, taping and bracing and shock absorbing shoes for your child.

The foot orthoses are important for some children that tend to have a more pronated foot. This means that when they walk there foot tends to flatten out more causing additional pull on the connective tissue attaching to their heel. It has been observed that there is a correlation between pronated feet and Sever’s disease. So, designing orthoses that fit your child will help to prevent them from flattening out their foot and will often relieve the pain they are experiencing. Taping and bracing can help to limit the motion of the ankle joint during activity causing less irritation to occur. After the symptoms have been relieved, shock absorbing shoes can help to prevent the pain from reoccurring. If your child is still experiencing pain though, the doctor may suggest some pain killers to help offer some relief.

Sever’s Disease is a condition that will eventually go away once your child has finished forming bone in their heel. However, it can be a very painful and self-limiting condition and it is important to seek medical assistance for the matter.

The Bump That's Got You Stumped

So, you are feeling pain on your heels when you wear your tight dress shoes or you go running. The discomfort you are feeling could be due to Haglund’s Deformity. It earned its nickname, because it often hurts the most when women are wearing their high heels. However, this is not a condition that only affects women. This comes from an enlarged bone on the heel that is irritated when your shoe rubs up against the enlarged bone. This deformity can cause pain in the area of your Achille’s tendon, swelling, redness and tenderness. Often times, you will find that wearing backless shoes will relieve the pain. This is because there is nothing applying pressure to your heel. However, for most of us, we can’t wear these shoes all day long.

With many other foot issues, this results from particular foot types. These include walking on the outside of your foot, a high arch and an inflamed Achille’s tendon. After years of repetitive walking on this part of your foot, the Haglund’s deformity will form and cause a broad spectrum of pain for the individual. This can be a condition that can limit your activity.

Your podiatrist can help relieve this pain through several different treatment plans. These depend on how large the bump is. This can be determined through X-Ray and from this a treatment plan that will best suit you can be determined. This can range from padding to surgery.

Choosing to work through the pain can lead to additional injury. The deformity can cause the bursa between the tendon and the bone to become inflamed. This leads to a condition called bursitis. By seeking immediate medical attention initially, you can prevent these other complications from occurring.

Since this condition is a result of a foot type, it is important to correct the underlying issue. Orthotics can be used to prevent you from walking on the outer edge of your heel. Your podiatrist can make an orthotic that matches your particular foot and can be made for the type of shoes you wear day-to-day. By correcting your foot type, it can help to prevent this problem from occurring in the future.

Waking Up On The Wrong Side Of The Bed: Plantar Fasciitis

The beautiful fall weather is upon us.  This means colorful leaves, apple picking and cooler weather ideal for running. Runners are athletes that are prone to many different types of injuries due to the repetitive pounding of their foot against the ground throughout their stride. Some of the foot problems that occur can be a result of the individual’s foot type. One of these is known as plantar fasciitis.

Plantar fasciitis is a condition that results from doing the same motion over and over pulling and stretching a band of tissue on the bottom of your foot connecting the heel to the toes and contributing to your arch. This has been known to happen in construction workers that are standing on a roof all day, soldiers spending the day marching in formation and athletes who are constantly stretching and relaxing this band. It is a condition that is very common in middle-aged people, but is all present in younger people that are on their feet a lot.

For patients that have a flat foot type, where there is a constant stretch on that band of tissue, it becomes irritated over time and causes a great deal of pain. People will notice that their heel will suddenly be really sore when they first get out of bed or after they have been sitting for a long time. This pain can range from just enough to be annoying to being severe enough to cause debilitation. The condition is a relatively straight-forward one to treat, and something that a podiatrist sees on a regular basis. Often, the pain will be temporarily treated to get you back up on your feet, but for a long lasting effect, orthoses can be designed for your specific foot type. Orthoses give you long lasting relief by correcting your foot allowing it to avoid this flat position and prevent the constant stretch of your fascia. These orthoses can be designed to fit in any good quality running shoe and will in no way hinder the athlete. It will actually help you to get back out there and enjoy the sport without the pain that has been holding you back.

A common mistake is to try and push yourself through the pain. With this condition and many others, not treating the cause will lead to a greater amount of damage and a longer recovery time. For a runner, this means more time sitting out from your sport. In extreme cases, surgery could be necessary. So, to help prevent this, it is important to seek podiatric care as soon as you start to notice that something is not right. One of the many perks of being an athlete is that you know your body well, so make sure that you treat it right!